Reducing the complications from community acquired pneumonia: a review

Community-acquired pneumonia (CAP) represents a major healthcare burden worldwide, associated with significant morbidity and mortality. Management of the acute infection centres around the administration of antibiotic therapy alongside other supportive measures, particularly in those with sepsis. This includes fluid resuscitation, supplemental oxygen and intensive care admission in severe cases. This forms the mainstay of clinical practice and falls outside the scope of this review. There is a growing understanding in the literature that CAP is associated with complications extending well beyond the initial infectious episode. Increased cardiovascular risk, functional decline related to sarcopenia, disease recurrence and persistent symptomology prompting healthcare re-engagement have become increasingly recognised, however there is much less consensus on their management. This review will focus on the current literature regarding interventions aimed at mitigating these longer-term complications. Specifically, we evaluate evidence on the use of antiplatelet, cholesterol-lowering and anticoagulant therapies for cardiovascular risk reduction, physical therapy rehabilitation for functional recovery, adjunctive macrolide therapy for immunomodulatory benefit and optimising discharge planning to reduce healthcare reconsultation. This review aims to appraise the existing evidence base for each intervention, identifying opportunities to refine post-CAP care to inform future longitudinal research and develop clinical practice.